| NPI | 1538202924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PU4831) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS26406) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |